The Comparison of Astigmatic Outcomes after Cataract Surgery of Inferior versus Superior Clear Corneal Incision

ABSTRACT

PURPOSE: To analyze the difference in astigmatism and the mean change in total astigmatism between inferior clear corneal incision and superior clear corneal incision following cataract surgery in surgically-induced astigmatism (SIA). METHODS: Fifty-five eyes of 55 patients with with-the-rule astigmatism >0.5 diopters were evaluated. Patients were divided into two groups according to incision location (Group 1, 26 eyes with an inferior incision; Group 2, 29 eyes with a superior incision). Patients were evaluatied one month postoperatively. Uncorrected visual acuity (UCVA, log MAR), best-corrected visual acuity (BCVA, log MAR), SIA and mean change in corneal astigmatism were measured in both groups. RESULTS: One month postoperatively, mean UCVA was 0.15 +/- 0.17 log MAR in Group 1 and 0.23 +/- 0.24 log MAR in Group 2 (p = 0.253). Mean BCVA was 0.08 +/- 0.13 and 0.08 +/- 0.12 log MAR in Groups 1 and 2, respectively (p = 0.926). The SIA was 0.50 +/- 0.17 diopter and 0.57 +/- 0.34 diopter (p = 0.253) and mean change in total astigmatism was 0.50 +/- 0.96 diopter and 0.38 +/- 0.86 diopter in Groups 1 and 2, respectively (p = 0.426). CONCLUSIONS: There was no statistically significant difference between the two groups. Thus, corneal incision on the inferior side in patients of with-the-rule astigmatism can reduce the SIA and mean change in corneal astigmatism for patients with glaucoma, hard upper eyelid tension or sunken eye.